Motivating disability pensioners with back pain to return to work--a randomized controlled trial.

OBJECTIVE To investigate the outcome of a brief vocational-oriented intervention aiming to motivate disability pensioners with back pain to return to work, and to evaluate prognostic factors for having entered a return to work process during the following year. DESIGN A randomized controlled trial was conducted. SUBJECTS Participants (n = 89) (mean age 49 years, 65% women) who had received disability pension for more than one year were randomized into an intervention group (education, reassurance, motivation, vocational counselling, n = 45) and a control group (n = 44). METHODS Primary outcome measures were return to work or having entered a return to work process. Secondary outcome measures were life satisfaction, disability, fear avoidance behaviour and expectancy. RESULTS The intervention had no statistically significant effect on return to work or having entered a return to work process at 1-year follow-up. Twice as many in the intervention group (n = 10, 22%) had entered a return to work process compared with the controls (n = 5, 11%). The number needed to treat was 9.2 (95% confidence interval (CI) = 3.4, Inf). Only minor differences in secondary outcome measures were demonstrated. Positive expectancy, better physical performance and less pain were related to return to work. CONCLUSION The effort of returning disability pensioners to work by a brief vocational-oriented intervention may be of clinical relevance. The effect needs to be explored further in larger samples of disability pensioners.